Organization Active NPI

Christina Haemmerle PHD PC

  • Clinical Psychologist
  • Rochester Hills, MI
National Provider Identifier
1396894424
Registry record updated Nov 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301010779 Issued in MI
Legal business name
CHRISTINA HAEMMERLE PHD PC
Practice address
2565 S Rochester Rd
Suite 108B
Rochester Hills, MI 48307-4472
Phone
(248) 852-7907
NPI assigned
Jan 9, 2007
Last updated
Nov 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christina Haemmerle, PH.D.NPI 1134314529
Title
President
Phone
(586) 321-8115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301010779 MI Primary

Addresses

Primary practice location

2565 S Rochester Rd
Suite 108B
Rochester Hills, MI 48307-4472

Mailing address

55680 Lancewood Dr
Shelby Township, MI 48316-5808
Phone (586) 207-1069

Other identifiers 1

IdentifierTypeStateIssuer
350883000OtherMIMAGELLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071105000171 MI Part B Supplier - Clinic/Group Practice 0840387098 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester Hills, MI; Saint Clair Shores, MI

National Provider Directory

National Provider Directory

Locations

2565 S Rochester Rd
Ste 10
Rochester Hills, MI 48307

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289606400000",
    "number": "1396894424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55680 LANCEWOOD DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165808",
            "telephone_number": "586-207-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 S ROCHESTER RD",
            "address_2": "SUITE 108B",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074472",
            "telephone_number": "248-852-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINA HAEMMERLE PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-11-13",
        "status": "A",
        "authorized_official_last_name": "HAEMMERLE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-321-8115",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "350883000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.